• Title/Summary/Keyword: treatment strategy

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The In-hospital Clinical Outcomes of Extracorporeal Life Support after Adult Cardiovascular Surgery (성인 심혈관 수술 후 시행한 체외순환보조의 조기 임상결과)

  • Yie, Kil-Soo;Na, Chan-Young;Oh, Sam-Sae;Kim, Jae-Hyun;Ryu, Se-Min;Park, Sung-Min;Cho, Seong-Joon
    • Journal of Chest Surgery
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    • v.42 no.4
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    • pp.464-472
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    • 2009
  • Background: We analyzed the clinical results and the factors for survival of patients who underwent extracorporeal life support system after adult cardiovascular surgery. Material and Method: We retrospectively reviewed the medical record of 44 patients (1.6% of the total adult cardiovascular surgical cases) who underwent the use of a ventricular assisted device or extracorporeal membrane oxygenation from January 2002 to August 2008. There were 32 (72.7%) males and their mean age was 61.7$\pm$14.9(range: 20$\sim$73) years old. The mean duration of extracorporeal life support system was 5.3$\pm$3.0 (range: 1$\sim$12) days. Result: Of these 44 patients, 24 (54.5%) patients were successfully weaned from the extracorporeal device. Eighteen (40.9%) survivors were able to be discharged from the hospital. Complications were noted in 38 patients (86.4%). An emergency operation, no usage of a concomitant intraaortic balloon pump and major complications during use of the extra corporeal life support system such as bleeding, flow instability and renal failure were identified as significant risk factors for poor survival on univariated analysis. Owing to educational support and a continuous renal replacement therapy system, the clinical outcomes of these patients have improved since 2006. On multivariated analysis, renal failure and bleeding during extracorporeal life support were significant risk factors for poor survival. Conclusion: Although using. extracorporeal life support systems after adult cardiovascular surgery revealed acceptable clinical results, determining the optimal treatment strategy and further well designed larger studies are needed to improve the survival rate of patients who undergo extracorporeal life support after adult cardiovascular surgery.

Dry Matter Yield and Nutrients Uptake of Sorghum${\times}$Sudangrass Hybrid Grown with Different Rates of Livestock Manure Compost (가축분퇴비 시용 수준에 따른 수수${\times}$수단그라스 교잡종의 건물생산 및 양분 흡수)

  • Lim, Sang-Sun;Lee, Sang-Mo;Lee, Seung-Heon;Choi, Woo-Jung
    • Korean Journal of Soil Science and Fertilizer
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    • v.43 no.4
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    • pp.458-465
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    • 2010
  • To investigate the growth and nutrient uptake response of sorghum${\times}$sudangrass ($S{\times}S$) hybrid to different rate of livestock manure compost, a field experiment was conducted in the experimental grassland of Chonnam National University. Six treatments were laid out in a randomized block design with triplicates; control (no input), synthetic fertilizer (20 g N $m^{-2}$ and 20 g $P_2O_5\;m^{-2}$), compost 1 (3.4 g N $m^{-2}$ and 3.6 g $P_2O_5\;m^{-2}$), compost 2 (6.8 g N $m^{-2}$ and 7.2 g $P_2O_5\;m^{-2}$), compost 4 (13.4 g N $m^{-2}$ and 14.4 g $P_2O_5\;m^{-2}$), and compost 6 (20.2 g N $m^{-2}$ and 21.6 g $P_2O_5\;m^{-2}$). Ninety days after treatment, above-ground parts of the plants were harvested and measured for dry matter yield (DMY) and amounts of nutrients (N and P) uptake. Synthetic fertilizer application achieved the greatest DMY (2.4 kg $m^{-2}$) and nutrient uptake (38.3 g N $m^{-2}$ and 15.3 g $P_2O_5\;m^{-2}$). Increasing compost application rate tended to enhance DMY accumulation and nutrient uptake (P<0.01), but DMYs of compost 4 (1.9 kg $m^{-2}$) and 6 (1.8 kg $m^{-2}$) treatments were not different. Therefore, it was suggested that application compost alone may not achieve DMY of $S{\times}S$ hybrid compatible to synthetic fertilizer application. As nutrient uptake efficiency data showed that availability of compost P could be better than SF, it might be a strategy to apply compost as P source with supplementary N application such as liquid manure, SF or green manure if necessary considering availability of N input and the yield goals.

Regulatory Mechanism of Radiation-induced Cancer Cell Death by the Change of Cell Cycle (세포주기 변화에 타른 방사선 유도 암세포 사망의 조절기전)

  • Jeong Soo-Jin;Jeong Min-Ho;Jang Ji-Yeon;Jo Wol-Soon;Nam Byung-Hyouk;Jeong Min-Za;Lim Young-Jin;Jang Byung Gon;Youn Seon-Min;Lee Hyung Sik;Hur Won Joo;Yang Kwang Mo
    • Radiation Oncology Journal
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    • v.21 no.4
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    • pp.306-314
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    • 2003
  • Purpose : In our Previous study, we have shown the main cel1 death pattern Induced by irradiation or protein tyrosine kinase (PTK) inhibitors in K562 human myeiogenous leukemic cell line. Death of the cells treated with irradiation alone was characterized by mitotic catastrophe and typical radiation-induced apoptosis was accelerated by herblmycin A (HMA). Both types of cell death were inhibited by genistein. In this study, we investigated the effects of HMA and genistein on cell cycle regulation and its correlation with the alterations of radiation-induced cell death. Materials and Methods: K562 cells In exponential growth phase were used for this study. The cells were Irradiated with 10 Gy using 6 MeV Linac (200-300 cGy/min). Immediately after irradiation, cells were treated with 250 nM of HMA or 25 $\mu$N of genistein. The distributions of cell cycle, the expressions of cell cycle-related protein, the activities of cyclin-dependent kinase, and the yield of senescence and differentiation were analyzed. Results: X-irradiated cells were arrested In the G2 phase of the cell cycle but unlike the p53-positive cells, they were not able to sustain the cell cycle arrest. An accumulation of cells in G2 phase of first ceil-cycle post-treatment and an increase of cyclin Bl were correlated with spontaneous, premature, chromosome condensation and mitotic catastrophe. HMA induced rapid G2 checkpoint abrogation and concomitant p53-independent Gl accumulation. HMA-induced cell cycle modifications correlated with the increase of CDK2 kinase activity, the decrease of the expressions of cyclins I and A and of CDK2 kinase activity, and the enhancement of radiation-induced apoptosis. Genistein maintained cells that were arrested in the G2-phase, decreased the expressions of cyclin Bl and cdc25c and cdc25C kinase activity, increased the expression of pl6, and sustained senescence and megakaryocytic differentiation. Conclusion: The effects of HMA and genistein on the radiation-induced cell death of KS62 cells were closely related to the cell cycle regulatory activities. In this study, we present a unique and reproducible model in which for investigating the mechanisms of various, radiation-induced, cancer cell death patterns. Further evaluation by using this model will provide a potent target for a new strategy of radiotherapy.

THE CLINICAL FEATURES OF THREE SUB-DIAGNOSED GROUPS OF TIC DISORDERS AND FACTORS RELATED WITH ILLNESS SEVERITY (틱 장애의 진단분류에 따른 임상특징과 질환 심각도와 연관된 변인들)

  • Jung, Hee-Yeon;Hwang, Jeong-Min;Chung, Sun-Ju
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.12 no.1
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    • pp.115-124
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    • 2001
  • Objective:The purpose of this study was to compare the clinical features of children with three subdiagnoses of tic disorder(transient tic disorder(TTD), chronic tic disorder(CTD) and Tourette’s disorder (TD)) and to exam the factors related with illness severity of them. Method:Subjects were 69 children who met DSM-IV criteria for tic disorder and 43 control children. All subjects were investigated demographic and clinical factors related to tic. The severity of tic was assessed with the Yale Global Tic Severity Scale(YGTSS) in tic disorder children. The Child Behavior Checklist(CBCL) was accomplished by parents of all subjects. Results:Children with TTD had not only shorter duration of tic symtoms but also milder tic severity and impairment than those with CTD and TD. They also had significantly lower scores on most CBCL subscales than children with CTD and TD, while they were similar with controls in all the CBCL subcale scores except aggressive behavior. Children with CTD and those with TD were similar to each other in clinical variables except number of tic symptom and scores on CBCL social problem subscale. The interference and intensity of motor tic symptoms and duration of tic symptoms were significant predictors of global impairment score on YGTSS, while the presence of comorbid ADHD was a preictor of the total behavior problem score of CBCL. Conclusion:These findings indicate that duration of tic symptoms and the presence of comorbid ADHD as well as the severity of tic symptoms strongly associated with the illness severity of children with tic disorder. These results also suggest that those clinical factors may be more important for assessing the severity of illness and determining the treatment strategy than the sub-diagnosis itself in children with tic disorder.

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Susceptibility of Field Populations of Plutella xylostella and Spodoptera exigua to Four Diamide Insecticides (4종의 Diamide계열 살충제에 대한 배추좀나방과 파밤나방의 지역계통별 감수성 평가)

  • Cho, Sun-Ran;Kyung, Yejin;Shin, Soeun;Kang, Won-Jin;Jung, Dae Hoon;Lee, Seung-Ju;Park, Geun-Ho;Kim, Sung Il;Cho, Sung Woo;Kim, Hyun Kyung;Koo, Hyun-Na;Kim, Gil-Hah
    • Korean journal of applied entomology
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    • v.57 no.1
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    • pp.43-50
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    • 2018
  • The present study evaluated the susceptibility of field populations of Plutella xylostella and Spodoptera exigua larvae to four diamide insecticides-chlorantraniliprole, cyantraniliprole, cyclaniliprole, and flubendiamide. All the four diamide insecticides induced 100% mortality in the populations from Seongju (SJ) and Geochang (GC) when treated at a concentration recommended for P. xylostella. However, a very low insecticidal activity was observed in the population from Pyeongchang (PC) with 42.3% 3 d after treatment with chlorantraniliprole. The relative resistance ratio of P. xylostella to cyclaniliprole was similar or low (0.1-6.3 folds) in all the four areas. However, the population from PC exhibited a high resistance ratio to chlorantraniliprole (1,196.3 folds), cyantraniliprole (105.6 folds), and flubendiamide (191.6 folds) compared with that of the susceptible strain P. xylostella. Further, the populations of S. exigua from Cheongju (CJ), Jindo (JD), and Yeonggwang (YG) were not completely controlled by the 4 diamide insecticides. These populations also showed high relative resistance ratio when compared with that of the susceptible strain S. exigua. In particular, the populations from CJ and JD showed 100,000-fold higher resistance ratio to flubendiamide. A comparison of susceptibility of S. exigua larvae to chlorantraniliprole between 2014 and 2017 showed that chlorantraniliprole induced 100% mortality in all populations in 2014, whereas a very low insecticidal activity was observed among the populations in 2017. The results of the present study indicate that the insect pests rapidly develop resistance to diamide insecticides. Therefore, alternative insecticides with a different mechanism of action and comprehensive control strategy are needed. This study can serve as a basis to control pests effectively using diamide insecticides.

Clinicopathologic Characteristics of and Prognosis for Patients with a Borrmann Type IV Gastric Carcinoma (Borrmann 4형 위암의 임상병리학적 특성과 예후)

  • Kim, Taeg-Hyun;Song, Kyo-Young;Kim, Seung-Nam;Park, Cho-Hyun
    • Journal of Gastric Cancer
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    • v.6 no.2
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    • pp.97-102
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    • 2006
  • Purpose: The prognosis for patients with a Borrmann type IV gastric cancer is extremely poor despite an aggressive surgical approach. We evaluated the clinicopathological features for Borrmann type IV cancers to find treatment strategy. Materials and Methods: The 1098 patients with advanced gastric cancer who underwent surgical resection between 1990 and 2001 were analyzed. These patients were divided into two groups: 81 patients with a Borrmann type IV carcinoma, and 1017 patients with all other types of gastric carcinomas. Results: Patients with a Borrmann type IV carcinoma were younger than those with other types, and female was prevalent (p=0.000). Of the patients with a Borrmann type IV gastric carcinoma, 68 patients (84%) were classified as stage III or IV at the initial diagnosis. The histologic type was commonly undifferentiated and serosal infiltration; nodal involvement and lymphatic invasion were more frequent in patients with a Borrmann type IV than in those with other types of cancer. Multivariate analysis confirmed that the extent of lymph node metastasis was a negative prognostic factor for Borrmann type IV gastric carcinomas. The curability for a Borrmann type IV carcinoma was only 53.1%, and peritoneal dissemination rate was 25.9%. The predominant pattern of recurrence for a Borrmann type IV gastric carcinoma was peritoneal dissemination, and it was significantly different with other types (93.1% vs 55.8%, P<0.05). The 5-year survival rate of patients with a Borrmann type IV gastric carcinoma was significantly lower than those of patients with other types of cancer, even though a curative resection had been accomplished (26% vs 63%, p<0.005). The 5-year survival rates of patients with a Borrmann type IV carcinoma following a curative resection were 44.9%, 24%, and 0% for stages II, III and IV, respectively (p<0.05). Conclusion: Because the prognosis for patients of a Borrmann type IV gastric cancer is extremely poor despite a curative resection, preoperative and/or intraperitoneal chemotherapy should be considered. And diagnostic laparoscopy and peritoneal cytology may be used to play an important role in accurate staging workup. (J Korean Gastric Cancer Assoc 2006;6:97-102)

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A Study on the Changes in Ventilator Care Rate and Outcome of Very Low Birth Weight Infants During Last Four Years (최근 4년간 극소 저출생 체중아의 인공 호흡기 치료율과 경과 변화에 관한 연구)

  • Jung, Byun Kyung;Kim, Yeoung Ju;Lee, Sang Geel
    • Clinical and Experimental Pediatrics
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    • v.46 no.11
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    • pp.1073-1079
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    • 2003
  • Purpose : Recently there has been a decrease in ventilator care rate and duration of very low birth weight infants(VLBWI) in Fatima Hospital. The aims of this study were to survey the frequency and duration of ventilation in VLBWI and to develop a non-invasive neonatal intensive care unit (NICU) policy. Methods : We performed a retrospective study of 284 newborn of infants less than 1,500 gm admitted to NICU and discharged from January 1998 to December 2001. Patients were intubated or applied continuous positive airway pressure(CPAP) via nasal prong immediately after presenting signs of respiratory distress. We analyzed epidemiologic data to study the changes in ventilator care rate, duration and outcome of ventilator care groups. Results : Of 284 newborn infants, 146 required invasive management, such as endotracheal intubation and assisted ventilation. The characteristics, the severity of clinical symptoms and laboratory findings in ventilator care groups at birth showed no significant differences. The annual proportion of infants requiring assisted ventilation decreased according to increasing gestational age. The median duration of ventilation decreased markedly from 6.0 days in 1998 to 2.7 days in 2001. Final complications and outcomes in ventilator care groups showed no significant differences. Conclusion : Our study shows a significant reduction in the invasiveness of the treatment of VLBW infants, which was not associated with an increased mortality or morbidity. A non-invasive strategy for the VLBW infant with minimal to moderate respiratory distress after birth in NICU is better than immediate invasive management. Non-invasive nasal CPAP is a simpler and safer method than invasive assisted ventilation.

A Study on Effective Planning Method of the Check-off Fund Program for Egg (계란자조금의 효과적인 조성방안에 관한 연구)

  • Kim, Dong Jin;Hong, Sung Kyu;Kim, Yoon doo
    • Korean Journal of Poultry Science
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    • v.44 no.1
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    • pp.51-57
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    • 2017
  • Subsequent to the introduction of the "Laws on Consumption Promotion of Livestock Products" in 2002, a mandatory check-off system for the egg industry was introduced in June 2009. Unlike other livestock products, the check-off on eggs is financed not from the sale of the egg-the end product-but from the spent hen. Variables such as the falling price of spent hens lead to a low financing rate; The present farm allotment rate of 14%, introduced in 2015, is much higher than the 0.2% to 0.3% check-off rate in other types of business, thus placing a huge burden on farms. When check-off is financed from the egg, it is expected that 6.5 billion won will be raised using a rate of 0.3% of sale proceeds, Therefore, it is urgent for the government to establish infrastructure to enable producers and merchants to do business through Grade & Packing centers. This can be achieved by the staged construction of local Grade & Packing centers. Check-off should continue to be financed from the present spent hen until this infrastructure is established, and an institutional strategy should be provided by the government to raise the financing rate accurately and transparently using statistical treatment of supply data for spent hens as a short-term alternative.

Early Identification of Gifted Young Children and Dynamic assessment (유아 영재의 판별과 역동적 평가)

  • 장영숙
    • Journal of Gifted/Talented Education
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    • v.11 no.3
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    • pp.131-153
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    • 2001
  • The importance of identifying gifted children during early childhood is becoming recognized. Nonetheless, most researchers preferred to study the primary and secondary levels where children are already and more clearly demonstrating what talents they have, and where more reliable predictions of gifted may be made. Comparatively lisle work has been done in this area. When we identify giftedness during early childhood, we have to consider the potential of the young children rather than on actual achievement. Giftedness during early childhood is still developing and less stable than that of older children and this prevents us from making firm and accurate predictions based on children's actual achievement. Dynamic assessment, based on Vygotsky's concept of the zone of proximal development(ZPD), suggests a new idea in the way the gifted young children are identified. In light of dynamic assessment, for identifying the potential giftedness of young children. we need to involve measuring both unassisted and assisted performance. Dynamic assessment usually consists of a test-intervene-retest format that focuses attention on the improvement in child performance when an adult provides mediated assistance on how to master the testing task. The advantages of the dynamic assessment are as follows: First, the dynamic assessment approach can provide a useful means for assessing young gifted child who have not demonstrated high ability on traditional identification method. Second, the dynamic assessment approach can assess the learning process of young children. Third, the dynamic assessment can lead an individualized education by the early identification of young gifted children. Fourth, the dynamic assessment can be a more accurate predictor of potential by linking diagnosis and instruction. Thus, it can make us provide an educational treatment effectively for young gifted children.

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Heat Shock Treatments Induce the Accumulation of Phytochemicals in Kale Sprouts (열처리에 의한 케일 새싹의 기능성물질 축적)

  • Lee, Min-Jeong;Lim, Sooyeon;Kim, Jongkee;Oh, Myung-Min
    • Horticultural Science & Technology
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    • v.30 no.5
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    • pp.509-518
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    • 2012
  • The objective of this study was to determine the effect of heat shock treatments on the phytochemicals including antioxidants and anticancer materials in kale (Brassica oleracea L. var. acephala) sprouts. In study I, kale sprouts grown under the growing system for four days were soaked at 40, 50, or $60^{\circ}C$ distilled water for 10, 30, or 60 seconds, and in study II, kale sprouts were soaked at $50^{\circ}C$ distilled water for 10, 20, 30, 45, or 60 seconds. After the heat shock treatments, the sprouts were transferred into normal growing conditions and recovered there for two days. Fresh and dry weights, electrolyte leakage, total phenolic concentration, antioxidant capacity, total flavonoid concentration, phenylalanine ammonia-lyase (PAL) activity, and glucosinolates content of the sprouts were measured before and after the heat shock treatments. As a result, there was a significant decrease in the fresh and dry weight of kale sprouts treated with heat shock compared with control at harvest in study I. Especially, heat shock at $60^{\circ}C$ lead to more pronounced growth inhibition compared with heat treatments at 40 and $50^{\circ}C$. Electrolyte leakage by cell collapse was the highest in the sprouts exposed to $60^{\circ}C$ distilled water, which agreed with the growth results. Heat shock at $50^{\circ}C$ significantly induced the accumulation of phenolic compounds. In study II, fresh weight of kale sprouts at $50^{\circ}C$ heat shock showed a significant decrease compared with the control at one and two days after the treatment. However, the decrease was minimal and dry weight of kale sprouts was not significantly different from that in control. In contrast, the heat shock-treated kale sprouts had higher level of total phenolic concentration than control at harvest. Heat shock treatments at $50^{\circ}C$ for 20 seconds or more showed at least 1.5 and 1.2 times higher total phenolic concentration and antioxidants capacity than control, respectively. The change of the total flavonoid concentration was similar with that of antioxidants. PAL activity after 24 hours of heat shock was higher in all the heat shock-treated sprouts than that in control suggesting heat shock may stimulate secondary metabolic pathway in kale sprouts. Seven glucosinolates were identified in kale sprouts and soaking the sprouts with $50^{\circ}C$ water for 20 seconds had a pronounced impact on the accumulation of total glucosinolates as well as two major glucosinolates, progoitrin and sinigrin, at harvest. In conclusion, this study suggests that heat shock using hot water would be a potential strategy to improve nutritional quality of kale sprouts by inducing the accumulation of phytochemicals with antioxidant and anticancer properties.